Incidence and risk factors for hepatocellular carcinoma in 967 patients with cirrhosis.

PURPOSE: To determine the incidence of hepatocellular carcinoma in cirrhosis and to examine the influence of age and sex, and the contribution of etiological factors. METHODS: 967 patients with liver cirrhosis and free of hepatocellular carcinoma were enrolled in this longitudinal, retrospective and observational study. Monitoring for hepatocellular carcinoma was scheduled at 3- to 6-month intervals. The mean (+/-SD) length of follow-up was 60.3+/-51.7 months (range 6 258). RESULTS: During the observation period, hepatocellular carcinoma developed in 64 patients. The calculated annual incidence was 2.1%. The probability of being free of liver cancer was 92% at 5 years, 80% at 10 years, and 69% at 15 years. Age was the only independent risk factor for the development of malignancy in the multivariate analysis. There were no differences according to male sex, alcohol abuse, and chronic hepatitis B and C virus infection. CONCLUSIONS: The annual incidence of hepatocellular carcinoma was 2.1%. These results, although confirming that age is a risk factor for hepatocellular carcinoma in cirrhosis, indicate that alcohol abuse, male sex, and concurrent hepatitis B and C virus infection do not involve a higher risk of developing liver cancer.

[The hepatitis C virus among the prison population of Valencia]. / Virus C de la hepatitis entre la población penitenciaria de Valencia.

AIM: To know the prevalence of anti-VHC in the Valencia Male Penitentiary Centre. DESIGN: A prospective study in which a representative sample of the inmates is included. In each case the anti-VHC and the ALT are studied. Serological results were correlated with history of intravenous drug addiction, alcohol abuse and duration and number of internments. INMATES: 750 inmates are included; they represent 41% of the people interned in this Centre during 1991. RESULTS: A high prevalence (45%) of the serological marker for VHC infection was observed. The prevalence of anti-VHC+ among the drug addict inmates is around 90% and this situation was already found during the first year of drug addiction. Among non-drug addict inmates the prevalence is 14%. Hepatitis C virus infection has a correlation with the duration and number of internments; 75% of the inmates with high ALT values have anti-VHC+. CONCLUSIONS: Nearly half of the inmates are infected with hepatitis C virus. The drug addict inmates are infected during the first year of their habit. The majority of the inmates with elevated ALT has anti-VHC+.